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Ju B, Lee J, Kim HM, Lee CG, Song H. Impact of neck posture and insulating stick use on neck disability in Korean line workers: a cross-sectional study. Ann Occup Environ Med 2024; 36:e11. [PMID: 38741681 PMCID: PMC11090668 DOI: 10.35371/aoem.2024.36.e11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 05/16/2024] Open
Abstract
Background Occupational neck disability is a prevalent issue, especially among line workers, who are often exposed to elevated levels of cervical ergonomic stress. The aim of this study was to investigate the impact of neck posture and insulating stick use on neck disability in a specific occupational group in Korea. Methods This cross-sectional study was conducted among 483 line workers in Gwangju and Jeonnam, Korea. Data were collected using the Neck Disability Index, Cervical Degenerative Index, and a structured questionnaire focusing on demographic and occupational factors. Logistic regression analysis was applied to determine the adjusted odds ratio (OR) and 95% confidence interval (CI) for neck posture and factors related to neck disability. Results Neck disability prevalence was 17.2% among the participants. Multivariate logistic regression analysis showed that factors related to neck disability included age over 60 years (adjusted OR: 3.08; 95% CI: 1.63-5.83), depression (adjusted OR: 8.33; 95% CI: 3.85-18.00), a history of cervical trauma (adjusted OR: 2.13; 95% CI: 1.04-4.40), and radiological degenerative changes in the cervical spine (adjusted OR: 2.33; 95% CI: 1.26-4.33). In particular, the adjusted OR of neck disability among live-line workers was 2.10 (95% CI: 1.12-3.92) when compared with support workers (model 1). Other analysis models showed that use of insulating sticks for more than 10 hours per week (adjusted OR: 2.46; 95% CI: 1.32-4.61) and higher neck extension (adjusted OR: 2.98; 95% CI: 1.14-3.46) were significant work-related risk factors (model 2,3). Conclusions Neck posture, age, depression, cervical trauma history, degenerative changes in the cervical spine, and use of insulating sticks are significant risk factors for neck disability among line workers in Korea. These findings highlight the need to improve the working environment and reduce the burden of cervical ergonomic stress among line workers.
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Affiliation(s)
- Bounggyun Ju
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
| | - Jaehoo Lee
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
| | - Hye-min Kim
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
| | - Chul Gab Lee
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
| | - Hansoo Song
- Department of Occupational and Environmental Medicine, Chosun University Hospital, Gwangju, Korea
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Sawada T, Okawara H, Nakashima D, Aoki K, Namba M, Iwabuchi S, Katsumata Y, Nakamura M, Nagura T. Local alternating heat and cold stimulation affects hemodynamics and oxygenation in fatigued muscle tissue and autonomic nervous activity: a single-arm interventional study. J Physiol Anthropol 2024; 43:11. [PMID: 38528599 DOI: 10.1186/s40101-024-00358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/20/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Local alternating heat and cold stimulation as an alternative to contrast bath may cause intermittent vasoconstriction and vasodilation, inducing a vascular pumping effect and consequently promoting increased tissue blood flow and oxygenation. This study aimed to examine the effects of local alternating heat and cold stimulation, using a wearable thermal device, on the hemodynamics of fatigued muscle tissue and autonomic nervous activity. METHODS Twenty healthy individuals experienced fatigue in the periarticular muscles of the shoulder joint due to a typing task. Local alternating heat and cold stimulations were then applied to the upper trapezius muscle. Muscle hardness was measured using a muscle hardness meter, and muscle tissue hemodynamics and oxygenation were evaluated using near-infrared spectroscopy before and after the stimulation. Autonomic nervous activity was also evaluated using heart rate variability. RESULTS Alternating heat and cold stimulation decreased muscle hardness of the fatigued trapezius muscle from 1.38 ± 0.15 to 1.31 ± 0.14 N (P < 0.01). The concentration of total hemoglobin in the trapezius muscle tissue increased from - 0.21 ± 1.36 to 2.29 ± 3.42 µmol/l (P < 0.01), and the tissue hemoglobin oxygen saturation also increased from 70.1 ± 5.4 to 71.1 ± 6.0% (P < 0.05). Additionally, the heart rate variability parameter, which is an index of sympathetic nervous activity, increased from 3.82 ± 2.96 to 6.86 ± 3.49 (P < 0.01). A correlation was found between increased tissue hemoglobin oxygen saturation and increased parameters of sympathetic nervous activity (r = 0.50, P < 0.05). CONCLUSIONS Local alternating heat and cold stimulation affected the hemodynamic response in fatigued muscle tissue and autonomic nervous activity. This stimulation is more efficient than conventional contrast baths in terms of mobility and temperature control and has potential as a new versatile therapeutic intervention for muscle fatigue. TRIAL REGISTRATION UMIN-CTR (UMIN000040087: registered on April 7, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000045710 . UMIN000040620: registered on June 1, 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046359 ).
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Affiliation(s)
- Tomonori Sawada
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hiroki Okawara
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Nakashima
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
- Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Kentaro Aoki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Mira Namba
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Shuhei Iwabuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yoshinori Katsumata
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Department of Cardiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Yamada T, Yajima H, Takayama M, Imanishi K, Takakura N. Corrugator Muscle Activity Associated with Pressure Pain in Adults with Neck/Shoulder Pain. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:223. [PMID: 38399511 PMCID: PMC10890133 DOI: 10.3390/medicina60020223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: No studies have reported corrugator muscle activity associated with pain in people with pain. This study aimed to develop an objective pain assessment method using corrugator muscle activity with pressure pain stimulation to the skeletal muscle. Methods: Participants were 20 adults (a mean ± SD age of 22.0 ± 3.1 years) with chronic neck/shoulder pain. Surface electromyography (sEMG) of corrugator muscle activity at rest (baseline) and without and with pressure pain stimulation applied to the most painful tender point in the shoulder was recorded. Participants evaluated the intensity of the neck/shoulder pain and the sensory and affective components of pain with pressure stimulation using a visual analogue scale (VAS). The percentages of integrated sEMG (% corrugator activity) without and with pressure pain stimulation to the baseline integrated sEMG were compared, and the relationships between the % corrugator activity and the sensory and affective components of pain VAS scores were evaluated. Results: Without pressure stimulation, an increase in corrugator muscle activity due to chronic neck/shoulder pain was not observed. The % corrugator activity with pressure pain stimulation was significantly higher than that without stimulation (p < 0.01). A significant positive correlation between corrugator muscle activity and the affective components of pain VAS scores with pressure stimulation was found (ρ = 0.465, p = 0.039) and a tendency of positive correlation was found for the sensory component of pain VAS scores (ρ = 0.423, p = 0.063). Conclusions: The increase in corrugator muscle activity with pressure pain stimulation to the tender point in adults with chronic neck/shoulder pain was observed, although increased corrugator muscle activity resulting from the chronic neck/shoulder pain was not. These findings suggest that corrugator muscle activity with pressure pain stimulation can be a useful objective indication for tender point sensitivity assessment in the skeletal muscle with pain.
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Affiliation(s)
| | | | | | | | - Nobuari Takakura
- Department of Acupuncture and Moxibustion, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan; (T.Y.); (H.Y.); (M.T.); (K.I.)
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Ghafouri B, Rolander B, Gerdle B, Wåhlin C. Neck and shoulder pain and inflammatory biomarkers in plasma among forklift truck operators - A case-control study. Scand J Pain 2024; 24:sjpain-2023-0142. [PMID: 39215586 DOI: 10.1515/sjpain-2023-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES The aim of this study was to investigate a panel of inflammatory biomarkers in plasma from forklift truck operators (FLTOs) and healthy controls, and their relation to neck pain characteristics. METHODS From employees in a warehouse, 26 FLTOs were recruited and 24 healthy age- and sex-matched controls (CONs) were recruited via advertisement. The inclusion criterion for FLTOs was that they should operate reach decker and/or counterbalanced tilting mast forklift trucks. All participants were asked to answer a questionnaire covering demographic data, pain intensity numeric rating scale (NRS), anatomical spread, psychological distress, and health aspects. Pain sensitivity was measured using a pressure algometer. Blood samples were collected and analyzed for inflammatory proteins in plasma using a panel of 71 cytokines and chemokines. Multivariate data analysis including orthogonal partial least square-discriminant analysis (OPLS-DA) was performed to identify significant biomarkers. RESULTS Thirty percent of FLTOs reported NRS > 3 in the neck. Shoulder pain was common in 26% of the FLTOs. Pain and discomfort that most often prevented completion of activities were in the neck (20%), lower back (32%), and hips (27%). The FLTOs reported significantly (p = 0.04) higher levels of anxiety than the CON group and they had significantly lower pressure pain thresholds in the trapezius muscle on both right (p < 0.001) and left sides (p = 0.003). A significant OPLS-DA model could discriminate FLTOs from CON based on nine inflammatory proteins where the expression levels of four proteins were upregulated and five proteins were downregulated in FLTOs compared to CONs. Twenty-nine proteins correlated multivariately with pain intensity. CONCLUSIONS The profile of self-reported health, pain intensity, sensitivity, and plasma biomarkers can discriminate FLTOs with pain from healthy subjects. A combination of both self-reported and objective biomarker measurements can be useful for better understanding the pathophysiological mechanisms underlying work-related neck and shoulder pain.
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Affiliation(s)
- Bijar Ghafouri
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Bo Rolander
- Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85, Linköping, Sweden
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, and Department of Health, Medicine and Caring Sciences, Unit of Clinical Medicine, Linköping University, Linköping, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Mengi A, Bulut GT. The effect of combining physiotherapy with dry needling in patients with cervical spondylosis: A randomized controlled trial. J Back Musculoskelet Rehabil 2024; 37:1213-1221. [PMID: 38943380 DOI: 10.3233/bmr-230287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
BACKGROUND There are no data on the additional contribution of dry needling (DN) for trigger points (TPs) accompanying patients with cervical spondylosis (CS). OBJECTIVE To analyse the contribution of DN applied to concomitant active TPs in the upper trapezius muscle on the treatment outcomes of physiotherapy in CS. METHODS In this prospective randomized controlled study, 70 patients with CS and active TPs in the upper trapezius muscle were included. The first group received physiotherapy for 5 days per week for 3 weeks. The second group received DN with the same program. All participants were evaluated before treatment (day 0) and at the end of treatment (day 21) in terms of pain, functional status, quality of life, anxiety/depression scores, and number of TPs. RESULTS 33 patients in the first group and 32 patients in the second group completed the study. While the change over time was found significant in all variables, the change was not different between groups. The group-time interaction effect was not found to be statistically significant in any variable. Percentage changes of all variables were similar between the groups. CONCLUSION DN treatment added to the physiotherapy did not contribute to recovery in patients with CS.
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Affiliation(s)
- Alper Mengi
- Department of Pain Management, Edirne Sultan 1. Murat State Hospital, Edirne, Turkey
| | - Gül Tugba Bulut
- Department of Physical Medicine and Rehabilitation, Istanbul Training and Research Hospital, Istanbul, Turkey
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Ueda Y, Nakamata O, Kakizaki F, Natsuyama Y, Kawata S, Yakura T, Li ZL, Qu N, Itoh M. Relationship between scapular elevation exercises with different alignments and activity of the trapezius and levator scapulae muscles. J Phys Ther Sci 2023; 35:751-756. [PMID: 37915451 PMCID: PMC10618018 DOI: 10.1589/jpts.35.751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/21/2023] [Indexed: 11/03/2023] Open
Abstract
[Purpose] This study aimed to examine whether scapular elevation exercises in sitting positions with different alignments lead to contractions of the trapezius and levator scapulae muscles. [Participants and Methods] The participants were 25 males, measured in four sitting positions with different alignments. Spine alignment was assessed by measuring the head protrusion, upper thoracic spine tilt, and pelvic tilt angles. Upper limb alignment was evaluated using the scapula tilt angle, scapula rotation angle, and distance between scapular spinous processes. Scapular elevation exercises were measured, and the thickness of the trapezius and levator scapulae muscles were measured in resting and elevated positions, with changes in muscle thickness. [Results] The trapezius muscle thickness was greater in the sitting position with less thoracic spine tilt and scapula tilt angles. Conversely, the levator scapulae muscle thickness was greater in the sitting position with more thoracic spine tilt and scapula tilt angles. [Conclusion] Scapular elevation exercises induce separate contractions of the trapezius and levator scapulae muscles by modifying the alignment of the spine and upper limbs.
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Affiliation(s)
- Yasuhisa Ueda
- Department of Anatomy, Tokyo Medical University,
Japan
- Department of Physical Therapy, Faculty of Health Science
Technology, Bunkyo Gakuin University: 1196 Kamekubo, Fujimino, Saitama 356-8533,
Japan
| | - Osamu Nakamata
- Department of Physical Therapy, Faculty of Health Science
Technology, Bunkyo Gakuin University: 1196 Kamekubo, Fujimino, Saitama 356-8533,
Japan
| | - Fujiyasu Kakizaki
- Department of Physical Therapy, Faculty of Health Science
Technology, Bunkyo Gakuin University: 1196 Kamekubo, Fujimino, Saitama 356-8533,
Japan
| | | | | | - Tomiko Yakura
- Department of Anatomy, Tokyo Medical University,
Japan
| | | | - Ning Qu
- Department of Anatomy, Tokyo Medical University,
Japan
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University,
Japan
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Komoto N, Sakebayashi H, Imagawa N, Mizuno Y, Nakata I, Shigetoh H, Kodama T, Miyazaki J. Cluster Analysis of Subjective Shoulder Stiffness and Muscle Hardness: Associations with Central Sensitization-Related Symptoms. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1831. [PMID: 37893549 PMCID: PMC10608656 DOI: 10.3390/medicina59101831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Understanding the relationships between subjective shoulder stiffness, muscle hardness, and various factors is crucial. Our cross-sectional study identified subgroups of shoulder stiffness based on symptoms and muscle hardness and investigated associated factors. Materials and Methods: measures included subjective stiffness, pain, muscle hardness, and factors like physical and psychological conditions, pressure pain threshold, postural alignment, heart rate variability, and electroencephalography in 40 healthy young individuals. Results: Three clusters were identified: Cluster 1 with high stiffness, pain, and muscle hardness; Cluster 2 with low stiffness and pain but high muscle hardness; and Cluster 3 with low levels of all factors. Cluster 1 had significantly higher central sensitization-related symptoms (CSS) scores than Cluster 2. Subjective stiffness is positively correlated with psychological factors. Conclusions: our results suggest that CSS impacts subjective symptom severity among individuals with similar shoulder muscle hardness.
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Affiliation(s)
| | | | | | | | | | - Hayato Shigetoh
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho, Oyake, Yamashina-ku, Kyoto 607-8175, Japan (N.I.); (T.K.); (J.M.)
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8
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Opara M, Kozinc Ž. Which muscles exhibit increased stiffness in people with chronic neck pain? A systematic review with meta-analysis. Front Sports Act Living 2023; 5:1172514. [PMID: 37712006 PMCID: PMC10498279 DOI: 10.3389/fspor.2023.1172514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Chronic neck pain (CNP) substantially impacts quality of life, posing both personal challenges and economic strains. This systematic review sought to discern muscle-specific stiffness differences between CNP patients and individuals without CNP. Methods We searched the PubMed, Scopus, and PEDro databases for studies using ultrasound elastography or myotonometry to compare muscle stiffness between CNP patients and asymptomatic controls. Using a meta-analysis with a random-effects model, we derived the pooled effect as standardized mean difference (SMD). Results Out of the six studies selected, the adjusted Newcastle-Ottawa rating scale for cross-sectional studies denoted three as moderate-quality and three as high-quality. Our findings indicate that the upper trapezius (UT) stiffness was elevated in CNP patients compared to their counterparts without CNP (SMD = 0.39, 95% CI = 0.05 to 0.74; p = 0.03; small effect size). The data for other muscles remained inconclusive. Discussion Given the case-control design of all reviewed studies, a direct causative link between UT stiffness and CNP is yet to be confirmed. As such, recommending a reduction in trapezius muscle stiffness as a primary rehabilitation strategy for CNP patients is still inconclusive and further research is needed.
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Affiliation(s)
- Manca Opara
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Department of Health Studies, Andrej Marušič Institute, University of Primorska, Koper, Slovenia
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9
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Iavernig T, Zanette M, Miani A, Ronchese F, Larese Filon F. Incidence of shoulder disorders in a cohort of healthcare workers from 2009 to 2020. Int Arch Occup Environ Health 2023:10.1007/s00420-023-01976-7. [PMID: 37162575 DOI: 10.1007/s00420-023-01976-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE To estimate the incidence of shoulder disorders in a cohort of Health Care Workers (HCWs). METHODS 4406 workers employed from 2009 to 2020, were included in the study. Occupational risk factors and jobs were assessed according to working history. Incident cases were defined in case of shoulder pain associated with functional limitations during the medical examination. The Cox regression model was used to calculate the Hazard Ratio (HR) for different work activities, adjusted for age, sex, body mass index, and previous musculoskeletal injuries, using clerks as the reference category. RESULTS The incidence rates of shoulder musculoskeletal disorder for men and women were 13.1 for 1000 person-years (CI 95% 10.6-16.3) and 20.1 for 1000 person-years (CI 95% 17.8-22.6) respectively. The adjusted HR was significantly increased with age (1.06, CI 95% 1.05-1.07), outpatient health activities (2.82, CI 95% 1.89-4.219), and wards health activity (2.37, CI 95% 1.68-3.33). CONCLUSION HCWs with high biomechanical risk such as nurses and healthcare assistants had a higher incidence of shoulder disorders. Actions are needed for better prevention in health care assistance.
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Affiliation(s)
- Thomas Iavernig
- Postgraduate School in Occupational Medicine, Unit of Occupational Medicine, University of Trieste, Via Della Pietà 2/2, 34129, Trieste, Italy
| | - Marta Zanette
- Postgraduate School in Occupational Medicine, Unit of Occupational Medicine, University of Trieste, Via Della Pietà 2/2, 34129, Trieste, Italy.
| | - Andrea Miani
- Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Federico Ronchese
- Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
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10
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Xie Y, Thomas L, Johnston V, Coombes BK. Cervical and axioscapular muscle stiffness measured with shear wave elastography: A comparison between different levels of work-related neck disability. J Electromyogr Kinesiol 2023; 69:102754. [PMID: 36773478 DOI: 10.1016/j.jelekin.2023.102754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/21/2022] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Assessing muscle mechanical properties in terms of stiffness may provide important insights into mechanisms underlying work-related neck pain. This study compared stiffness of cervical and axioscapular muscles between 92 participants (sonographers) with no (n = 31), mild (n = 43) or moderate/severe (n = 18) neck disability. It was hypothesized that participants with more severe neck pain and disability would present with altered distribution of stiffness in cervical and axioscapular muscles than those with no disability. Using shear wave elastography, the shear modulus (kPa) of five cervical and six axioscapular muscles or muscle segments were measured in a relaxed seated upright or side-lying position. Muscle activity was measured simultaneously using surface electromyography during the elastography measurements and scapular depression was measured using a measurement tape and inclinometer before the elastography measurements to evaluate their potential confounding influences on shear modulus. Increased shear modulus was found in deeper than superficial cervical muscles and more cranial than caudal axioscapular muscles. However, no differences in shear modulus of the cervical or axioscapular muscles were found between sonographers with varying levels of disability. This study suggests no alterations in stiffness of cervical and axioscapular muscles were associated with work-related neck pain and disability.
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Affiliation(s)
- Yanfei Xie
- RECOVER Injury Research Centre, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Health and Medical Sciences, University of Southern Queensland, Australia
| | - Brooke K Coombes
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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11
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Santiago RJ, Baptista JS, Magalhães A, Costa JT. Impact of a 10-min typing task in the development of trapezius myalgia: a preliminary observational study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:115-120. [PMID: 34989660 DOI: 10.1080/10803548.2022.2026064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. Computer use, as in typing, might contribute to trapezius myalgia (TM) development by increasing upper trapezius (UT) muscle fatigue. The purpose of this study is to investigate whether 10 min of performing a typing task by a population at risk would show significant changes in surface electromyography (sEMG) and pressure pain threshold (PPT) measurements. Supported and unsupported forearms postures are compared. Methods. Sixteen asymptomatic volunteers with minimum daily use of a computer of 5 h were randomized into two groups: fully supported forearms (n = 8) and unsupported forearms (n = 8). The protocol consisted of 10 min of a typing task, and the workstation was set according to the usual participant profile. sEMG and PPT readings were collected from both UT muscles. Results. PPT and sEMG readings were not significantly different among the two groups. Supported forearms had less reduction of PPT and a smaller increase in electrical activity. Conclusions. Ten minutes of typing seems insufficient to observe any significant changes that could lead to TM development.
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Affiliation(s)
- Rui José Santiago
- Faculty of Engineering, University of Porto, Portugal.,Porto Biomechanics Laboratory (Labiomep), University of Porto, Portugal
| | | | - André Magalhães
- School of Health Sciences, University Fernando Pessoa, Portugal
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12
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Medin-Ceylan C, Korkmaz MD, Sahbaz T, Cigdem Karacay B. Risk factors of neck disability in computer-using office workers: a cross-sectional study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:44-49. [PMID: 34952560 DOI: 10.1080/10803548.2021.2021712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04821024.
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Affiliation(s)
- Cansın Medin-Ceylan
- Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Training and Research Hospital, Turkey
| | - Merve Damla Korkmaz
- Department of Physical Medicine and Rehabilitation, Kanuni Sultan Süleyman Training and Research Hospital, Turkey
| | - Tugba Sahbaz
- Department of Physical Medicine and Rehabilitation, Kanuni Sultan Süleyman Training and Research Hospital, Turkey
| | - Basak Cigdem Karacay
- Department of Physical Medicine and Rehabilitation, Yerköy State Hospital, Turkey
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13
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Jawade S, Chitale N, Phansopkar P. The Effect of Reciprocal Inhibition Techniques on Pain, Range of Motion, and Functional Activities in Patients With Upper Trapezitis. Cureus 2023; 15:e34487. [PMID: 36874329 PMCID: PMC9982756 DOI: 10.7759/cureus.34487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/01/2023] [Indexed: 02/04/2023] Open
Abstract
Background and objective Upper trapezius can cause neck pain, and restrict functional activities and cervical range of motion (ROM), and hence its management should be part of a global rehabilitation program. Owing to the heterogeneity of the existing trials, various techniques of manual physical therapy might be potent, though the scope of their efficacy is currently unspecified. The reciprocal inhibition technique of the muscle energy technique (MET) works on both agonist as well antagonist muscles for the reduction of pain and to improve overall functional activities. The aim of this study was to analyze the effect of the reciprocal inhibition technique of MET on pain, cervical ROM, and functional activities in patients with upper trapezitis. Methods An interventional cross-sectional study involving 30 patients with neck pain due to upper trapezitis was conducted. The outcome measures were as follows: numerical pain rating scale (NPRS) score for pain intensity, universal goniometer for cervical ROM, and neck disability index (NDI) score for functional activities. The reciprocal inhibition technique involved a five-second hold, five-second rest, followed by stretching with a 10-60-second hold, with five repetitions. Patients were treated for five sessions a week for two weeks. Results Paired t-test was used to compare the group's mean values before and after therapy. Our findings revealed that NPRS score, cervical ROM, and NDI score notably improved (p=0.001). Conclusion The reciprocal inhibition technique of MET in patients with upper trapezitis showed significant improvement in neck pain, cervical movement, and functional activities. Further studies with larger sample sizes are warranted to validate our findings.
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Affiliation(s)
- Swapna Jawade
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Neha Chitale
- Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND
| | - Pratik Phansopkar
- Department of Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Kim HA, Kwon OY, Yi CH, Jeon HS, Choi WJ, Weon JH. Altered muscle recruitment patterns during isometric shoulder abduction in individuals with chronic upper trapezius pain: a cross sectional study. BMC Musculoskelet Disord 2022; 23:1131. [PMID: 36575432 PMCID: PMC9793595 DOI: 10.1186/s12891-022-06030-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/25/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Upper trapezius (UT) pain with myofascial trigger points (MTrPs) can affect movement at the glenohumeral joint as well as at the scapulothoracic joint. The investigation of muscle recruitment patterns can discern motor control strategies. The purpose of this study was to compare shoulder muscle recruitment patterns and muscle activity according to various loads between individuals with and without chronic UT pain. METHODS In this cross-sectional study, twenty-four participants that had UT pain with MTrPs and sex, age, body weight matched 24 controls with no UT pain were recruited. Surface EMG electrodes were attached to the UT, the serratus anterior (SA), the lower trapezius (LT) and the middle deltoid (MD). All participants performed isometric shoulder abduction with a load of 25%, 50%, or 75% of the maximum strength at 60° of shoulder abduction. The EMG activity, the activity ratio (SA/UT, LT/UT, MD/UT), and the relative contribution of each muscle activity were calculated. RESULTS MD activity was significantly decreased in the UT pain group compared to that in the control group (p < 0.05). The EMG activity ratio of SA/UT (p < 0.025) and the relative contribution of SA activity to shoulder abduction (p < 0.05) were significantly greater in the UT pain group than in the control group in the 25% loading condition. CONCLUSION The results of present study showed that UT pain with MTrPs may increase the relative contribution of SA activity and decrease MD activity at low loads. Altered recruitment patterns of scapular upward rotators can be altered in the proper scapular position, which results in decreased MD activity. Clinicians should consider altered recruitment patterns when managing UT pain. TRIAL REGISTRATION Clinical Research Information Service: Clinical Research Information Service (KCT0007370; 08/06/2022).
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Affiliation(s)
- Hyun-A Kim
- grid.27476.300000 0001 0943 978XDepartment of Physical therapy, Nagoya University, 1-1-20 Daiko-Minami, Higashi-ku, Aichi Prefecture Nagoya City, Japan
| | - Oh-Yun Kwon
- grid.15444.300000 0004 0470 5454Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, 1 Yonseidae-gil, Gangwon-Do 26493 Wonju, South Korea
| | - Chung-Hwi Yi
- grid.15444.300000 0004 0470 5454Department of Physical Therapy, Yonsei University, 1 Yonseidae-gil, Gangwon-Do 26493 Wonju, South Korea
| | - Hye-Seon Jeon
- grid.15444.300000 0004 0470 5454Department of Physical Therapy, Yonsei University, 1 Yonseidae-gil, Gangwon-Do 26493 Wonju, South Korea
| | - Woochol Joseph Choi
- grid.15444.300000 0004 0470 5454Department of Physical Therapy, Yonsei University, 1 Yonseidae-gil, Gangwon-Do 26493 Wonju, South Korea
| | - Jong-Hyuck Weon
- grid.444004.00000 0004 0647 1620Department of Physical Therapy, Joongbu University, 201 Daehak-ro, Chubu-myeon, Chungcheongnam-do Geumsan-gun, South Korea
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15
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Almushahhim M, Nuhmani S, Joseph R, Muslem WHA, Abualait T. Short-Term Effects of Dry Needling with a Standard Exercise Program on Pain and Quality of Life in Patients with Chronic Mechanical Neck Pain. J Clin Med 2022; 11:6167. [PMID: 36294487 PMCID: PMC9604617 DOI: 10.3390/jcm11206167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND This study aimed to determine the short-term effects of dry needling (DN) combined with a standard exercise program on pain and quality of life in patients with chronic mechanical neck pain (CMNP). METHODS Thirty-one patients with CMNP were randomly allocated to the experimental and control groups. The experimental group received DN and underwent a standard exercise program (one DN session and six exercise sessions) for two weeks, whereas the control group underwent the same exercise program alone for two weeks. The participants' scores in the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), Short Form-36 Quality of Life Scale (SF-36 QOLS), and Beck Depression Inventory (BDI) before and after the intervention were assessed. RESULTS The control and experimental groups' post-test NDI, NPRS, SF-36 QOLS, and BDI scores significantly differed from their baseline scores (p ≤ 0.05). The between-group comparison of the post-test scores using Wilcoxon rank-sum test revealed no significant differences between the NDI, NPRS, BDI, and SF-36 QOLS scores of both groups (p ≥ 0.05). CONCLUSIONS One session of trigger point DN (TrP-DN) with exercise and exercise alone showed the same pain and quality-of-life outcomes after a two-week intervention. We did not recognise TrP-DN as an efficient intervention, not because we obtained evidence that it is ineffective, but because there were inadequate high-quality studies on the subject and unavailable data on the minimum quantity of injections required for better DN outcomes in CMNP patients.
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Affiliation(s)
- Muhannad Almushahhim
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 2435, Dammam 31451, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 2435, Dammam 31451, Saudi Arabia
| | - Royes Joseph
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Wafa Hashem Al Muslem
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 2435, Dammam 31451, Saudi Arabia
| | - Turki Abualait
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 2435, Dammam 31451, Saudi Arabia
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16
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Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Corrective exercises administered online vs at the workplace for pain and function in the office workers with upper crossed syndrome: randomized controlled trial. Int Arch Occup Environ Health 2022; 95:1703-1718. [PMID: 35391580 PMCID: PMC8989105 DOI: 10.1007/s00420-022-01859-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
Objective To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS). Methods We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up]. Results ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group. Conclusion Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home.
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Affiliation(s)
- Zohreh Yaghoubitajani
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Mehdi Gheitasi
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran.
| | - Mohammad Bayattork
- Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
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17
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Intolo P, Sitthikornpaiboon R, Chararivivot V. Pain and electromyography reduction cause of sitting upright posture, frequent break, eye rest and self-stretching during smartphone usage. Work 2022; 71:729-738. [DOI: 10.3233/wor-210825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Prolonged use of the smartphone causes neck and shoulder pain. However, no study has yet evaluated the effects of sitting upright, combined with frequent breaks, eye rest and self-stretching on pain and EMG during smartphone use. OBJECTIVES: The purpose of the study was to compare pain and muscle activity between the control group (rest only) and the intervention group (rest combined with correct posture, eye rest and self-stretching) in smartphone use for 41.30 minutes. METHOD: Forty-four healthy females aged 18–25 years old were recruited and randomly divided into two groups. The body pain chart and Visual Analog Scale (VAS) were used to evaluate pain. Electromyography (EMG) was used to measure muscle activity of Cervical Erector Spinae (CES) and Upper Trapezius (UT) muscles. RESULTS: The results showed that overall pain and neck pain in the control group increased significantly after smartphone use for 20 min and continually increased to 41.30 minutes (p < 0.05). Overall pain and neck pain in the intervention group was significantly lesser than control group after smartphone use for 41.30 minutes (p < 0.05). In the control group, EMG of CES at 41.30 minute was significantly higher than that of at 0 min (p < 0.05). There was no significant difference in EMG of UT between the two groups. CONCLUSION: Conclusion smartphone user in the interventional group reported less pain when compared to control group after Smartphone use for 41.30 minutes. Therefore, the user aged 18–25 years should have a rest combined with correct posture, eye rest and self-stretching to prevent neck pain during prolonged smartphone use.
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Affiliation(s)
- Pattariya Intolo
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | | | - Vararat Chararivivot
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
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18
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Sawada T, Okawara H, Nakashima D, Iwabuchi S, Matsumoto M, Nakamura M, Nagura T. Effects of alternating heat and cold stimulation using a wearable thermo-device on subjective and objective shoulder stiffness. J Physiol Anthropol 2022; 41:1. [PMID: 34980256 PMCID: PMC8722412 DOI: 10.1186/s40101-021-00275-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Technological innovations have allowed the use of miniature apparatus that can easily control and program heat and cold stimulations using Peltier elements. The wearable thermo-device has a potential to be applied to conventional contrast bath therapy. This study aimed to examine the effects of alternating heat and cold stimulation (HC) using a wearable thermo-device on subjective and objective improvement of shoulder stiffness. METHODS Twenty healthy young male individuals (20.3 ± 0.6 years) participated in this study. The interventions were randomly conducted under four conditions, including HC, heat stimulation, cold stimulation, and no stimulation on their bilateral trapezius muscle, after a 30-min typing task. Each intervention was administered at least 1 week apart. The analyzed limb was the dominant arm. Muscle hardness was assessed using a portable muscle hardness meter, as well as the skin temperature over the stimulated area. After each condition, the participants were asked for feedback regarding subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue using an 11-point numerical rating scale. RESULTS With regard to muscle hardness, only the HC condition significantly decreased from 1.43 N to 1.37 N (d = 0.44, p < 0.05). Additionally, reduced muscle hardness in HC condition was associated with the degree of skin cooling during the intervention (cold max: r = 0.634, p < 0.01; cold change: r = -0.548, p < 0.05). Subjective improvement in refreshed feelings, muscle stiffness, and muscle fatigue was determined in the HC and heat stimulation conditions compared with the no stimulation condition (p < 0.01 and p < 0.05, respectively). Moreover, the HC condition showed significantly greater improvements in muscle stiffness and fatigue compared to the cold stimulation condition (p < 0.05). CONCLUSIONS The current study demonstrated that HC promoted not only better subjective symptoms, such as muscle stiffness and fatigue, but also lesser muscle hardness. Furthermore, an association was observed between the degree of skin temperature cooling and reduced muscle hardness during HC. Further investigations on the ratio and intensity of cooling should be conducted in the future to establish the optimal HC protocol for muscle stiffness or fatigue. TRIAL REGISTRATION UMIN000040620 . Registered 1 June 2020.
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Affiliation(s)
- Tomonori Sawada
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hiroki Okawara
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Nakashima
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan. .,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Shuhei Iwabuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takeo Nagura
- Diagnosis and Treatment Division, Nagura Orthopedic Clinic, Chuo, Tokyo, Japan.,Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Online supervised versus workplace corrective exercises for upper crossed syndrome: a protocol for a randomized controlled trial. Trials 2021; 22:907. [PMID: 34895301 PMCID: PMC8665858 DOI: 10.1186/s13063-021-05875-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022] Open
Abstract
Background and objective Musculoskeletal disorders (MSDs) including upper crossed syndrome (UCS) are considered as the leading cause of work-related issues worldwide among office workers. Therefore, the present study aims to evaluate the effect of workplace-based versus online-supervised home-based corrective exercises among office workers with UCS. Methods and design To this end, 45 subjects within the age range of 30–45 years are randomly assigned to three groups in the present parallel-group, randomized control trial using a pretest-posttest design. These groups include the subjects who receive online-supervised exercise and workplace exercise containing three sessions of intervention for 8 weeks and the control group receives no intervention while performing routine activities. The primary outcome variables are neck-shoulder pain (NSP) and consequent sick leave due to NSP, followed by alignment, workability, and the surface electromyography of upper, middle, and lower trapezius (UT, MT, and LT), sternocleidomastoid (SCM), and serratus anterior (SA) as the secondary variables. Discussion The present study seeks to assess the effect of workplace versus online-supervised corrective exercise interventions among 45 office workers suffering from UCS. It is expected to improve and reduce the related symptoms including postural malalignment and imbalance muscles after 8 weeks of corrective exercises. If effective, the findings may lead to adherence and work performance among the office workers, and individuals subjected to UCS can use the benefits of an online-supervised intervention. In addition, the findings may be useful in different workplaces as the evidence for employers to benefit from the reduction in the related costs and side effects of work-related neck/shoulder disorders including work disability, productivity loss, time expense, social insurance, work absenteeism, and treatment costs. Finally, clinicians and corrective exercise therapists can consider it as a clinical based-evidence intervention for their further actions. Trial registration Iranian Registry of Clinical Trials IRCT20200729048249N1. Registered on 5 October 2020 (https://en.irct.ir/user/trial/49992/view)
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Affiliation(s)
- Zohreh Yaghoubitajani
- Department of Health and Sports Rehabilitation, Faculty of Sports Science and Health, Shahid Beheshti University, Tehran, Iran
| | - Mehdi Gheitasi
- Department of Health and Sports Rehabilitation, Faculty of Sports Science and Health, Shahid Beheshti University, Tehran, Iran.
| | - Mohammad Bayattork
- Sport Sciences and Physical Education, Faculty of Humanities Science, University of Hormozgan, Bandar Abbas, Iran
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Sport Sciences, Department of Health Science and Technology, Aalborg University, 9220, Aalborg, Denmark
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20
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Ducatti MHM, Waiteman MC, Botta AFB, Lopes HDS, Glaviano NR, Azevedo FMD, Briani RV. Knee flexor strength, rate of torque development and flexibility in women and men with patellofemoral pain: Relationship with pain and the performance in the single leg bridge test. Phys Ther Sport 2021; 50:166-172. [PMID: 34038835 DOI: 10.1016/j.ptsp.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the relationship between: (1) knee flexor strength, rate of torque development (RTD), and flexibility with pain level; (2) knee flexor strength and RTD with the performance in the single leg bridge test (SLBT) in women and men with patellofemoral pain (PFP). DESIGN Cross-sectional. SETTING Laboratory-based study. PARTICIPANTS 39 women and 36 men with PFP. MAIN OUTCOME MEASURES Knee flexor strength, RTD, and flexibility; performance in the SLBT, current, and worst pain level. RESULTS Moderate to strong significant negative relationships were identified between the current pain level with knee flexor strength (r = -0.57 to -0.34) and flexibility (r = -0.44 to -0.35); and between knee flexor strength and RTD with the performance in the SLBT (r = 0.34 to 0.57) in women and men with PFP. Knee flexor RTD was not related to any pain level and no significant relationships were identified between the worst pain level with knee flexor strength and flexibility in women and men with PFP. CONCLUSIONS Our results support the potential value of assessing knee flexor strength and flexibility in women and men with PFP. The SLBT may be a useful tool to assess knee flexor muscle capacity in individuals with PFP in a clinical setting.
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Affiliation(s)
- Matheus Henrique Maiolini Ducatti
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
| | - Marina Cabral Waiteman
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
| | - Ana Flávia Balotari Botta
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
| | - Helder Dos Santos Lopes
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
| | - Neal Robert Glaviano
- Department of Kinesiology, College of Agriculture, Health and Natural Resources, University of Connecticut (UCONN), Storrs, Connecticut, United States.
| | - Fábio Mícolis de Azevedo
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
| | - Ronaldo Valdir Briani
- Laboratory of Biomechanics and Motor Control (LABCOM), School of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, Sao Paulo, Brazil.
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Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073410. [PMID: 33806089 PMCID: PMC8037445 DOI: 10.3390/ijerph18073410] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders.
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22
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Reliability of Trapezius Muscle Hardness Measurement: A Comparison between Portable Muscle Hardness Meter and Ultrasound Strain Elastography. SENSORS 2020; 20:s20247200. [PMID: 33339151 PMCID: PMC7765603 DOI: 10.3390/s20247200] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022]
Abstract
Prolonged computer work and smartphone use can cause stiffness of the neck and shoulder muscles, including the trapezius muscle. Hence, muscle hardness quantification is clinically beneficial. The present study aimed to examine the reliability of trapezius muscle hardness measurement using a portable muscle hardness meter and ultrasound strain elastography. Overall, 20 healthy young men participated in this study. Prior to measurement, the participant’s subjective symptoms, particularly shoulder muscle stiffness, were rated using an 11-point verbal scale. Furthermore, hardness of the right and left upper trapezius muscles was assessed. In the strain elastography assessment, muscle hardness was evaluated using strain ratio. Results showed that, in quantifying upper trapezius muscle hardness, both portable muscle hardness meter and strain elastography had an excellent intra-tester reliability (>0.9). However, the correlation coefficients between muscle hardness values assessed using a muscle hardness meter and those evaluated with strain elastography did not significantly differ, and the scores for subjective shoulder stiffness did not correspond to muscle hardness values. Therefore, the hardness of the trapezius muscle does not directly reflect the subjective shoulder stiffness. Future studies should thoroughly examine the location of the shoulder stiffness, and check whether it is accompanied by local pain or tenderness.
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Comparing Central Pain Processing in Individuals With Non-Traumatic Neck Pain and Healthy Individuals: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2020; 21:1101-1124. [DOI: 10.1016/j.jpain.2020.02.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/16/2020] [Accepted: 02/23/2020] [Indexed: 12/29/2022]
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24
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The effectivity of trigger point dry needling in improving pain on people with upper trapezius myalgia. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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25
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Alfawaz S, Lohman E, Alameri M, Daher N, Jaber H. Effect of adding stretching to standardized procedures on cervical range of motion, pain, and disability in patients with non-specific mechanical neck pain: A randomized clinical trial. J Bodyw Mov Ther 2020; 24:50-58. [PMID: 32826008 DOI: 10.1016/j.jbmt.2020.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 01/31/2020] [Accepted: 02/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE to investigate the benefit of adding stretching exercises to cervical joint mobilization and active rotation exercises for patients with non-specific mechanical neck pain. METHODS Thirty-eight subjects with non-specific mechanical neck pain were randomly assigned to a standard procedure group (passive cervical mobilization and active cervical rotation range of motion exercise) or a combined procedure (passive cervical mobilization, active cervical rotation range of motion exercises, and stretching procedures). Mixed factorial analysis of variance was used to compare changes between groups over time in active cervical range of motion, Numeric Pain Rating Scale, Neck Disability Index, Global Rating of Change, and Pressure Pain Threshold. RESULTS There was a significant change in mean active range of motion in all directions, Pressure Pain Threshold, perceived pain, disability levels, and global rating of change over time (p < 0.001). There was a significant group by time interaction in mean active range of motion during extension (p = 0.01), right rotation (p = 0.004), right and left lateral flexion (p = 0.05, and p = 0.02 respectively). However, there was no significant group by time interaction in mean active range of motion during flexion, left rotation, pain intensity (p = 0.09), right and left pressure pain threshold (p = 0.30, 0.47, respectively), and disability (p = 0.07). CONCLUSIONS Both study groups improved significantly in all subjective and objective outcome measures. However, data from this study suggest that adding stretching to the standard procedures may be more effective than the standard procedure alone at improving cervical extension, right rotation, and lateral flexion active range of motion, but not pain and disability.
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Affiliation(s)
- Saad Alfawaz
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA; Department of Physical Therapy, College of Medical Rehabilitation Sciences, King Abdulaziz University, Saudi Arabia
| | - Everett Lohman
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Mansoor Alameri
- Department of Physical Therapy, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA; Brockton Physical Therapy, Riverside, CA, USA
| | - Noha Daher
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA
| | - Hatem Jaber
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA, USA; Department of Physical Therapy, School of Rehabilitative Sciences, University of St. Augustine for Health Sciences, Austin, TX, USA.
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Effectiveness of an Eye-Cervical Re-Education Program in Chronic Neck Pain: A Randomized Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2760413. [PMID: 32184889 PMCID: PMC7061123 DOI: 10.1155/2020/2760413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 12/04/2022]
Abstract
Objectives Proprioceptive training is popularly applied as a therapeutic exercise method in physiotherapy. Its effects on pain and range of motion are only poorly evaluated. Therefore, this study assesses the effectiveness of proprioceptive training with an Eye-Cervical Re-education Program to decrease pain and increase the joint range in chronic neck pain patients. Material and Methods. Design A randomized, no-blinded, controlled clinical trial. Setting. Physiotherapy consultation. Participants. 44 people were divided into two groups. Interventions. All patients were treated with a multimodal physiotherapy intervention. The experimental group was supplemented with an exercise program that included eye-cervical proprioception. Outcomes. The primary outcomes included pain pressure thresholds (upper trapezius, levator scapulae, and splenius capitis) and cervical range of motion. The secondary outcomes included pain measured by the Visual Analogical Scale and the McGillSpv Questionnaire. Results The proprioception treatment was effective in reducing the pain pressure threshold in the right upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius (p=0.001), left upper trapezius ( Conclusions The Eye-Cervical Re-education Program is effective at relieving pain pressure thresholds in the upper trapezius, right levator scapula, and left splenius capitis and especially effective for increasing the cervical range of motion. This trial is registered with NCT03197285 (retrospective registration).
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Qu N, Graven-Nielsen T, Lindstrøm R, Blogg Andersen Dc V, Hirata RP. Recurrent neck pain patients exhibit altered joint motion pattern during cervical flexion and extension movements. Clin Biomech (Bristol, Avon) 2020; 71:125-132. [PMID: 31726402 DOI: 10.1016/j.clinbiomech.2019.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Impaired sensorimotor ability has been demonstrated in recurrent neck pain patients. It is however not clear if cervical joint motion and pressure pain sensitivity in recurrent neck pain patients are different from asymptomatic controls. METHODS Cervical flexion and extension motions were examined by video-fluoroscopy and pressure pain thresholds were assessed bilaterally over C2/C3, C5/C6 facet joints and right tibialis anterior in eighteen recurrent neck pain patients and eighteen healthy subjects. Individual joint motion was analyzed by dividing fluoroscopic videos into 10 epochs. The motion opposite to the primary direction (anti-directional motion) and motion along with the primary direction (pro-directional motion) of each joint were extracted across epochs. Total joint motion was the sum of anti-directional and pro-directional motions. Joint motion variability was represented by the variance of joint motions across epochs. FINDINGS Compared to controls, recurrent neck pain patients showed: 1) decreased anti-directional motion at C2/C3 and C3/C4 (P < 0.05) and increased anti-directional motion at C5/C6 and C6/C7 (P < 0.05) during extension motion. 2) Increased overall anti-direction motion during flexion motion (P < 0.05). 3) Lower joint motion variability at C3/C4 during extension motion (P < 0.05). INTERPRETATION Recurrent neck pain patients showed a redistribution of anti-directional motion between the middle cervical spine and the lower cervical spine during cervical extension and increased overall anti-directional motion during cervical flexion compared with healthy controls. The anti-directional motion was more sensitive to neck pain compared to other cervical joint motion parameters in the present study.
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Affiliation(s)
- Ning Qu
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Rene Lindstrøm
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark
| | | | - Rogerio Pessoto Hirata
- SMI, Department of Health and Science Technology, Faculty of Medicine, Aalborg University, Denmark.
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Wang-Price S, Zafereo J, Brizzolara K, Mackin B, Lawson L, Seeger D, Lawson S. Psychometric Properties of Pressure Pain Thresholds Measured in 2 Positions for Adults With and Without Neck-Shoulder Pain and Tenderness. J Manipulative Physiol Ther 2019; 42:416-424. [PMID: 31337510 DOI: 10.1016/j.jmpt.2018.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 06/11/2018] [Accepted: 11/02/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the psychometric properties of pressure pain threshold (PPT) testing in adults with and without neck-shoulder pain and tenderness and to compare the differences in PPT measurements between the seated and prone positions. METHODS Thirty asymptomatic adults and 30 symptomatic patients with intermittent neck-shoulder pain and tenderness completed the study. A pressure algometer was used to assess PPTs at specific points on the middle deltoid, levator scapulae, and upper trapezius muscles of the dominant side of the asymptomatic individuals and the painful side of the patients. Four trials were performed on each muscle in both the seated and prone positions. To determine between-day reliability, a subset of the participants returned to repeat the testing. RESULTS The intraclass correlation coefficients showed good to excellent within-session reliability and fair to excellent between-day reliability of PPT measurements in both the seated and prone positions for both groups. There were significant differences between groups for all muscles in both positions (P < .05) except for the upper trapezius muscle in the prone position. In addition, significant differences were found between the 2 testing positions for the middle deltoid and upper trapezius muscles in the symptomatic group and for the middle deltoid muscle in the asymptomatic group. CONCLUSION The results of the study suggest that PPT testing could be useful for distinguishing individuals with and without neck-shoulder pain and tenderness. Further, the patient's position should be considered when testing PPT, specifically at the middle deltoid or upper trapezius muscles.
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Affiliation(s)
- Sharon Wang-Price
- School of Physical Therapy, Texas Woman's University, Dallas, Texas.
| | - Jason Zafereo
- Department of Physical Therapy, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kelli Brizzolara
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Brendan Mackin
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Larry Lawson
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Dayna Seeger
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
| | - Shannon Lawson
- School of Physical Therapy, Texas Woman's University, Dallas, Texas
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Cabral AM, Moreira RDFC, de Barros FC, Sato TDO. Is physical capacity associated with the occurrence of musculoskeletal symptoms among office workers? A cross-sectional study. Int Arch Occup Environ Health 2019; 92:1159-1172. [DOI: 10.1007/s00420-019-01455-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
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Xie Y, Thomas L, Hug F, Johnston V, Coombes BK. Quantifying cervical and axioscapular muscle stiffness using shear wave elastography. J Electromyogr Kinesiol 2019; 48:94-102. [PMID: 31272075 DOI: 10.1016/j.jelekin.2019.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess intra-rater (intra-session and inter-day) reliability and influence of side dominance and the scapular resting position on the shear modulus (an index of stiffness) of resting cervical and axioscapular muscles. Sixteen healthy participants were recruited. On day one, ultrasound shear wave elastography was used to measure the shear modulus of superficial and deep cervical extensor and axioscapular muscles bilaterally. Clinical assessments of scapular resting position were performed bilaterally. On day two, testing was repeated on the dominant side. Both intra-session and inter-day reliability were good to excellent for shear modulus of superficial muscles, and poor to excellent for deep muscles. Side differences of shear modulus for posterior upper trapezius were statistically significant but clinically irrelevant. The shear modulus of posterior upper trapezius and middle trapezius were significantly correlated with scapular depression. Ultrasound shear wave elastography is a reliable tool for quantitatively assessing stiffness of superficial cervical and axioscapular muscles. The influence of scapular position should be considered in future comparative studies of healthy controls and patients with neck/shoulder pain. This study provides the necessary first step for future studies on assessing and interpreting the stiffness of cervical and axioscapular muscles for neck and shoulder musculoskeletal disorders.
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Affiliation(s)
- Yanfei Xie
- School of Health and Rehabilitation Science, The University of Queensland, Australia.
| | - Lucy Thomas
- School of Health and Rehabilitation Science, The University of Queensland, Australia
| | - François Hug
- Laboratory "Movement, Interactions, Performance" (EA 4334), UFR STAPS, University of Nantes, France; Institut Universitaire de France (IUF), Paris, France; School of Biomedical Sciences, The University of Queensland, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Science, The University of Queensland, Australia; RECOVER Injury Research Centre, The University of Queensland, Australia
| | - Brooke K Coombes
- School of Health and Rehabilitation Science, The University of Queensland, Australia; School of Allied Health Sciences, Griffith University, Australia
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Gomes CAFDP, Dibai-Filho AV, Politti F, Gonzalez TDO, Biasotto-Gonzalez DA. Combined Use of Diadynamic Currents and Manual Therapy on Myofascial Trigger Points in Patients With Shoulder Impingement Syndrome: A Randomized Controlled Trial. J Manipulative Physiol Ther 2018; 41:475-482. [DOI: 10.1016/j.jmpt.2017.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 11/26/2022]
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Changes in stiffness of the dorsal scapular muscles before and after computer work: a comparison between individuals with and without neck and shoulder complaints. Eur J Appl Physiol 2016; 117:179-187. [DOI: 10.1007/s00421-016-3510-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
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Weinschenk S, Göllner R, Hollmann MW, Hotz L, Picardi S, Hubbert K, Strowitzki T, Meuser T. Inter-Rater Reliability of Neck Reflex Points in Women with Chronic Neck Pain. ACTA ACUST UNITED AC 2016; 23:223-9. [PMID: 27607183 DOI: 10.1159/000447506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neck reflex points (NRP) are tender soft tissue areas of the cervical region that display reflectory changes in response to chronic inflammations of correlated regions in the visceral cranium. Six bilateral areas, NRP C0, C1, C2, C3, C4 and C7, are detectable by palpating the lateral neck. We investigated the inter-rater reliability of NRP to assess their potential clinical relevance. METHODS 32 consecutive patients with chronic neck pain were examined for NRP tenderness by an experienced physician and an inexperienced medical student in a blinded design. A detailed description of the palpation technique is included in this section. Absence of pain was defined as pain index (PI) = 0, slight tenderness = 1, and marked pain = 2. Findings were evaluated either by pair-wise Cohen's kappa (ĸ) or by percentage of agreement (PA). RESULTS Examiners identified 40% and 41% of positive NRP, respectively (PI > 0, physician: 155, student: 157) with a slight preference for the left side (1.2:1). The number of patients identified with >6 positive NRP by the examiners was similar (13 vs. 12 patients). ĸ values ranged from 0.52 to 0.95. The overall kappa was ĸ = 0.80 for the left and ĸ = 0.74 for the right side. PA varied from 78.1% to 96.9% with strongest agreement at NRP C0, NRP C2, and NRP C7. Inter-rater agreement was independent of patients' age, gender, body mass index and examiner's experience. CONCLUSION The high reproducibility suggests the clinical relevance of NRP in women.
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Affiliation(s)
- Stefan Weinschenk
- Outpatient Practice Drs. Weinschenk, Scherer & Co., Karlsruhe, Germany
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Kang MH, Choi JY, Oh JS. Effects of Crossed Brassiere Straps on Pain, Range of Motion, and Electromyographic Activity of Scapular Upward Rotators in Women With Scapular Downward Rotation Syndrome. PM R 2015; 7:1261-1268. [PMID: 26032346 DOI: 10.1016/j.pmrj.2015.05.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/19/2015] [Accepted: 05/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Scapular downward rotation syndrome manifests as an abnormally downward-rotated scapula at rest or with arm motion and typically results in neck and shoulder pain. The brassiere strap has been suggested as a possible contributing factor to scapula downward rotation and pain in the upper trapezius because of increased downward rotational force on the lateral aspect of the scapula. No study, however, has examined the influences of a modified brassiere strap on pain in and the function of the scapular muscles. OBJECTIVE To examine the effects of crossed brassiere straps on the pressure pain threshold (PPT) of the upper trapezius, neck rotation range of motion (ROM), and electromyographic activity of the scapular upward rotators in females with scapular downward rotation syndrome. DESIGN Cross-over design. SETTING Laboratory. PARTICIPANTS In total, 15 female subjects with scapular downward rotation syndrome were recruited at hospitals and a local university. METHODS All participants performed neck rotation and humeral elevation under 2 different conditions: parallel and crossed brassiere straps. MAIN OUTCOME MEASUREMENTS The PPT of the upper trapezius was measured using an analog algometer, whereas neck rotation ROM was quantified with a 3-dimensional ultrasonic motion analysis system. The electromyographic activities of the upper trapezius, serratus anterior, and lower trapezius during humeral elevation were assessed with a surface electromyography system. Outcome measures were assessed under parallel and crossed brassiere strap conditions, and differences in outcomes between the conditions were analyzed using a paired t-test. RESULTS The PPT and neck rotation ROM were increased when the subject was wearing the brassiere with crossed versus parallel straps (P < .001). Greater electromyographic activities of the serratus anterior, lower trapezius, and lesser upper trapezius muscles during humeral elevation were found under the crossed strap condition than the parallel strap condition (P < .05). CONCLUSIONS These findings provide useful information for clinicians when designing management programs to decrease pain and improve biomechanical function for females with scapular downward rotation syndrome.
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Affiliation(s)
- Min-Hyeok Kang
- Department of Physical therapy, Graduate School, INJE University, Gimhae, South Korea
| | - Ji-Young Choi
- Division of Physical Therapy, Changwon Himchanhospital, Changwon, South Korea
| | - Jae-Seop Oh
- Department of Physical Therapy, College of Biomedical Science and Engineering, INJE University, 607 Obang-dong, Gimhae-si, Gyeongsangnam-do, South Korea, 621-749
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Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clin Rehabil 2015; 30:64-72. [PMID: 25780258 DOI: 10.1177/0269215515575747] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 02/08/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the effectiveness of neck and shoulder stretching exercises for relief neck pain among office workers. DESIGN Randomized controlled trial. SETTING An outpatient setting. PARTICIPANTS A total of 96 subjects with moderate-to-severe neck pain (visual analogue score ⩾5/10) for ⩾3 months. INTERVENTIONS All participants received an informative brochure indicating the proper position and ergonomics to be applied during daily work. The treatment group received the additional instruction to perform neck and around shoulder stretching exercises two times/day, five days/week during four weeks. MAIN OUTCOMES Pain, neck functions, and quality of life were evaluated at baseline and week 4 using pain visual analogue scale, Northwick Park Neck Pain Questionnaire, and Short Form-36, respectively. RESULTS Both groups had comparable baseline data. All outcomes were improved significantly from baseline. When compared between groups, the magnitude of improvement was significantly greater in the treatment group than in the control group (-1.4; 95% CI: -2.2, -0.7 for visual analogue scale; -4.8; 95% CI: -9.3, -0.4 for Northwick Park Neck Pain Questionnaire; and 14.0; 95% CI: 7.1, 20.9 for physical dimension of the Short Form-36). Compared with the patients who performed exercises <3 times/week, those who exercised ⩾3 times/week yielded significantly greater improvement in neck function and physical dimension of quality of life scores (p = 0.005 and p = 0.018, respectively). CONCLUSION A regular stretching exercise program performed for four weeks can decrease neck and shoulder pain and improve neck function and quality of life for office workers who have chronic moderate-to-severe neck or shoulder pain.
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Affiliation(s)
- Punjama Tunwattanapong
- Division of Rehabilitation Medicine, Sunprasitthiprasong Hospital, Ubonratchatani, Thailand
| | - Ratcharin Kongkasuwan
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Pecos-Martín D, Montañez-Aguilera FJ, Gallego-Izquierdo T, Urraca-Gesto A, Gómez-Conesa A, Romero-Franco N, Plaza-Manzano G. Effectiveness of dry needling on the lower trapezius in patients with mechanical neck pain: a randomized controlled trial. Arch Phys Med Rehabil 2015; 96:775-81. [PMID: 25582412 DOI: 10.1016/j.apmr.2014.12.016] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/15/2014] [Accepted: 12/18/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the effect of dry needling into a myofascial trigger point (MTrP) in the lower trapezius muscle of patients with mechanical idiopathic neck pain. DESIGN A single-center, randomized, double-blinded controlled study. SETTING Patients were recruited from the student population of a local hospital by advertisement in the university clinic from January 2010 to December 2011. PARTICIPANTS Patients (N=72) with unilateral neck pain, neck pain for ≥3 months, and active trigger points in the lower trapezius muscle were randomly assigned to 1 of 2 treatment groups. All the patients completed the study. INTERVENTIONS Dry needling in an MTrP in the lower trapezius muscle, or dry needling in the lower trapezius muscle but not at an MTrP. MAIN OUTCOME MEASURES The visual analog scale (VAS), Neck Pain Questionnaire (NPQ), and pressure-pain threshold (PPT) were assessed before the intervention and 1 week and 1 month postintervention. RESULTS Treatment with dry needling of the lower trapezius muscle close to the MTrP showed decreases in pain and PPT as well as an improvement in the degree of disability (P<.001) compared with the baseline and control group measurements (P<.001). The dry-needling technique performed in the MTrP showed more significant therapeutic effects (P<.001). CONCLUSIONS The application of dry needling into an active MTrP of the lower trapezius muscle induces significant changes in the VAS, NPQ, and PPT levels compared with the application of dry needling in other locations of the same muscle in patients with mechanical neck pain.
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Affiliation(s)
| | | | | | - Alicia Urraca-Gesto
- Rehabilitation and Physical Therapy Department, University Hospital Alcorcón Foundation, Madrid, Spain
| | - Antonia Gómez-Conesa
- Department of Physical Therapy, Faculty of Medicine, Murcia University, Murcia, Spain
| | | | - Gustavo Plaza-Manzano
- Physical Medicine and Rehabilitation Department, Medical Hydrology, Faculty of Medicine, Complutense University Madrid, Madrid, Spain.
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Jay K, Brandt M, Sundstrup E, Schraefel M, Jakobsen MD, Sjøgaard G, Andersen LL. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol. BMC Musculoskelet Disord 2014; 15:444. [PMID: 25519844 PMCID: PMC4325961 DOI: 10.1186/1471-2474-15-444] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/15/2014] [Indexed: 12/03/2022] Open
Abstract
Background Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor control and may result in extended periods of time spent in static positions. In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions, multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges. The aim of this study is therefore to investigate the effect of an individually tailored biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. Methods/design In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants receive either an individualized multifactorial intervention or “usual care” for 10 weeks at the worksite. Inclusion criteria: 1) female laboratory technician (18-67 years of age) and 2) Pain intensity ≥ 3 (0-10 Visual Analogue Scale) lasting ≥3 months with a frequency of ≥ 3 days per week in one or more of the following regions: i) upper back i) low back iii) neck, iv) shoulder, v) elbow and/or vi) hand. Exclusion criteria: 1) life-threatening disease and 2) pregnancy. Stress, as measured by Cohen´s perceived stress questionnaire is not an inclusion criteria, thus participants can participate regardless of their stress level. We will implement an individualized intervention addressing biopsychosocial elements of musculoskeletal pain with the following components; i) increasing physical capacity through strength- and motor control training; ii) lowering or preventing development of stress through mindfulness practice and learning de-catastrophizing pain management strategies through cognitive training. The primary outcome at 10-week follow-up is the between-group difference in intensity of perceived musculoskeletal pain during the last week (average value of back, neck, shoulder, elbow and hand) assessed by questionnaire (modified visual analogue scale 0-10). Discussion This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress. Trial registration number ClinicalTrials.gov NCT02047669. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-444) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kenneth Jay
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.
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Process evaluation of workplace interventions with physical exercise to reduce musculoskeletal disorders. Int J Rheumatol 2014; 2014:761363. [PMID: 25574172 PMCID: PMC4276703 DOI: 10.1155/2014/761363] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/19/2014] [Indexed: 11/23/2022] Open
Abstract
Process evaluation is important to explain success or failure of workplace interventions. This study performs a summative process evaluation of workplace interventions with physical exercise. As part of a randomized controlled trial 132 office workers with neck and shoulder pain were to participate in 10 weeks of elastic resistance training five times a week at the workplace; the 2 min group performed a single set of lateral raise to failure, and the 12 min group performed 5-6 sets with 8–12 repetitions. Participants received a single instructional session together with a training diary and manual at baseline (100% dose delivered and 100% dose received), and 59 and 57 participants, respectively, replied to the process evaluation questionnaire at 10-week follow-up. Results showed that in the 2 and 12 min groups, respectively, 82% and 81% of the participants completed more than 30 training sessions. However, two-thirds of the participants would have preferred more than a single exercise to vary between. In the 12 versus 2 min group more participants experienced the training sessions as too long (30% versus 5%). Most participants (67–92%) found the training diary and manual helpful, adequacy in a single instructional session, and satisfaction with the type of training. Among those with low adherence, lack of time (51%) and difficulties in starting exercising after illness (26%) were common barriers for regular training. Among those with low adherence, 52% felt that five training sessions per week were too much, and 29% would rather have trained a completely different kind of exercise. In conclusion, resistance training at the workplace is generally well received among office workers with neck-shoulder pain, but a one-size-fits-all approach is not feasible for all employees.
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The occurrence of the cervical pain syndromes in parents of children with physical disability in the population of Poland. Disabil Health J 2014; 8:278-83. [PMID: 25458974 DOI: 10.1016/j.dhjo.2014.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 09/23/2014] [Accepted: 09/27/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pain in the cervical spine area is one of the main health problems of inhabitants of Western Europe. The necessity of parents' taking care of a child with physical disability is connected with parents' exposure to the factors affecting the risk of occurrence of pain in the cervical spine. OBJECTIVE The objective of this study was to analyze whether there are differences in the occurrence of cervical spine pain between the group of parents of children with physical disability and parents of children without a disability. METHOD The research included a group of parents of school-aged children with physical disability (n = 47) and a group of parents of children without disability (n = 69), aged between 29 and 60 years from the Silesian Voivodeship (Poland). The people taking part in the research were asked to complete two questionnaires: Visual Analogue Scale (VAS) for the cervical spine and Neck Disability Index (NDI) questionnaire. Means, standard deviations, and ranges to compare scores across groups were calculated. RESULTS The mean VAS score among parents of children with physical disability was 4.22 (SD = 3.23) compared to 2.16 (SD = 2.31; p < .001) among parents of children without physical disability. Similarly, mean NDI scores were 19.6 (SD = 15.12) and 9.68 (SD = 8.84; p < .001), respectively. CONCLUSIONS The parents of children with physical disability are to a greater extent exposed to the occurrence of cervical spine pain. Therefore, suitable training as regards ergonomics, especially during lifting, transferring and transporting children might be beneficial to these parents.
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Ghafouri N, Ghafouri B, Fowler CJ, Larsson B, Turkina MV, Karlsson L, Gerdle B. Effects of two different specific neck exercise interventions on palmitoylethanolamide and stearoylethanolamide concentrations in the interstitium of the trapezius muscle in women with chronic neck shoulder pain. PAIN MEDICINE 2014; 15:1379-89. [PMID: 24995488 DOI: 10.1111/pme.12486] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Chronic neck/shoulder pain (CNSP) is one of the most common pain conditions. The understanding of mechanisms, including the peripheral balance between nociceptive and antinociceptive processes, is incomplete. N-acylethanolamines (NAEs) are a class of endogenous compounds that regulate inflammation and pain. The aim of this study was to investigate the levels of two NAEs: the peroxisome proliferator-activated receptor type-α ligand palmitoylethanolamide (PEA) and stearoylethanolamide (SEA) in the muscle interstitium of the trapezius muscle in women with CNSP randomized to two different neck specific training programs and in a healthy pain-free control group (CON). MATERIALS AND METHODS Fifty-seven women with CNSP were randomized to strength + stretch or stretch alone exercise programs. Twenty-nine subjects underwent microdialysis procedure before and after 4-6 months of exercise. Twenty-four CON subjects underwent microdialysis procedure before and after 4-6 months without any intervention in between. Microdialysate samples were collected from the trapezius muscle and analyzed by mass spectrometry for PEA and SEA levels. RESULTS PEA and SEA levels were significantly higher in CNSP patients compared with CON. PEA was significantly higher in CNSP than in CON after both training programs. SEA was significantly higher in CNSP than in CON after stretch alone but not after strength + stretch training. A significant positive correlation was found between changes in pain intensity and in SEA levels in the strength + stretch group, but not in the stretch alone group. CONCLUSION Our results indicate that exercise interventions differentially affect the levels of the bioactive lipids PEA and SEA in the interstitium of the trapezius muscle in women with CNSP.
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Affiliation(s)
- Nazdar Ghafouri
- Rehabilitation Medicine, Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Pain and Rehabilitation Centre, County Council of Östergötland, Linköping, Sweden; Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
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Andersen CH, Andersen LL, Zebis MK, Sjøgaard G. Effect of scapular function training on chronic pain in the neck/shoulder region: a randomized controlled trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:316-24. [PMID: 23832167 PMCID: PMC4000422 DOI: 10.1007/s10926-013-9441-1] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE Neck and shoulder complaints are common among employees in occupations characterized by intensive computer use. Treatment has varied from passive rest to active treatments and active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach. The purpose of this study was in a randomised controlled trial to investigate if intensive scapular function training (SFT)-in terms of training of the lower trapezius and the serratus anterior muscle while minimizing direct training of the upper trapezius-is effective in reducing pain in adults with chronic non-specific pain in the neck/shoulder region. METHODS 47 office workers with chronic non-specific pain in the neck/shoulder region were randomized to 10 weeks 3 × 20 min SFT with training supervision or to a control group. At baseline and at follow-up the participants were tested for maximum isometric shoulder strength by a blinded tester. Further, once a week participants reported pain intensity of the neck/shoulder during the previous week. RESULTS In intention-to-treat analysis neck- and shoulder pain decreased 2.0 (95 % CI 0.35; 3.64) in SFT compared with control group (p < 0.05). Pressure Pain Threshold (PPT) increased 129 kPa in the lower trapezius in SFT compared with the control group (p < 0.01). Shoulder elevation strength increased 7.7 kg in SFT compared with the control group (p < 0.01) with no change in shoulder protraction strength. CONCLUSIONS SFT reduces pain intensity and increases shoulder elevation strength in adults with chronic non-specific pain in the neck/shoulder region. The magnitude of improvement in pain intensity was clinically relevant.
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Affiliation(s)
- Christoffer H Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen Ø, Denmark,
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Ashina S, Bendtsen L, Lyngberg AC, Lipton RB, Hajiyeva N, Jensen R. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia 2014; 35:211-9. [PMID: 24853166 DOI: 10.1177/0333102414535110] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND We assessed the prevalence of neck pain in the population in relation to headache. METHODS In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. RESULTS The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted OR 3.0, 95% CI 2.0-4.4, p<0.001). Adjusting for age, gender, education and poor self-rated health, in comparison with those without headaches, the prevalence of neck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (p<0.05 for all three group comparisons). Individuals with neck pain had higher TTS than individuals without neck pain (15.1±10.5 vs. 8.4±8.0, p<0.001). CONCLUSIONS Neck pain is highly prevalent in the general population and even more prevalent in individuals with primary headaches. Prevalence is highest in coexistent M+TTH, followed by pure TTH and migraine. Myofascial tenderness is significantly increased in individuals with neck pain.
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Affiliation(s)
- Sait Ashina
- Department of Pain Medicine and Palliative Care, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, NY, USA Department of Neurology, Headache Program, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, NY, USA Danish Headache Center and Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark
| | - Lars Bendtsen
- Danish Headache Center and Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark
| | - Ann C Lyngberg
- Unit for Quality and Patient Safety, Capital Region of Denmark, Denmark
| | - Richard B Lipton
- Department of Neurology, Montefiore Headache Center, and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, NY, USA
| | - Nazrin Hajiyeva
- Department of Pain Medicine and Palliative Care, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Rigmor Jensen
- Danish Headache Center and Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark
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Association between Neck/Shoulder Pain and Trapezius Muscle Tenderness in Office Workers. PAIN RESEARCH AND TREATMENT 2014; 2014:352735. [PMID: 24800070 PMCID: PMC3985383 DOI: 10.1155/2014/352735] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/17/2014] [Accepted: 02/19/2014] [Indexed: 01/20/2023]
Abstract
Background. Neck/shoulder pain is a common musculoskeletal disorder among adults. The pain is often assumed to be related to muscular tenderness rather than serious chronic disease. Aim. To determine the association between neck/shoulder pain intensity and trapezius muscle tenderness in office workers. Methods. 653 employees from two large office workplaces in Copenhagen, Denmark, replied to a questionnaire on health and working conditions (mean: age 43 years, body mass index 24 kg·m−2, computer use 90% of work time, 73% women). Respondents rated intensity of neck/shoulder pain during the previous three months on a scale of 0–10 and palpable tenderness of the upper trapezius muscle on a scale of “no tenderness,” “some tenderness,” or “severe tenderness.” Odds ratios for tenderness as a function of neck/shoulder pain intensity were determined using cumulative logistic regression controlled for age, gender, and chronic disease. Results. The prevalence of “no,” “some,” and “severe” tenderness of the trapezius muscle was 18%, 59%, and 23% in women and 51%, 42%, and 7% in men, respectively (chi-square, P < 0.0001). Participants with “no,” “some,” and “severe” tenderness of the trapezius muscle, respectively, rated their neck/shoulder pain intensity to 1.5 (SD 1.6), 3.8 (SD 2.0), and 5.7 (SD 1.9) for women and 1.4 (SD 1.4), 3.1 (SD 2.2), and 5.1 (SD 1.7) for men. For every unit increase in neck/shoulder pain intensity, the OR for one unit increase in trapezius tenderness was 1.86 (95% confidence interval 1.70 to 2.04). Conclusion. In office workers, a strong association between perceived neck/shoulder pain intensity and trapezius muscle tenderness exists. The present study provides reference values of pain intensity among office workers with no, some, and severe tenderness of the trapezius muscle.
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Andersen LL. Ask the Experts: Chronic neck pain: risk factors, consequences and solutions. Pain Manag 2014; 3:263-7. [PMID: 24654811 DOI: 10.2217/pmt.13.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Lars L Andersen, MSc PhD, is Professor of Musculoskeletal Disorders at National Research Centre for the Working Environment in Copenhagen (Denmark). With a background in exercise physiology, he has a special interest in the effect of strength training on health, performance and disease. Currently, he performs epidemiological and interventional research primarily in the field of musculoskeletal disorders, but also in psychosocial work environment, behavioral psychology, stroke, early aging, physical activity and workplace health promotion. He has led several research projects and published more than 90 original articles with peer-review in international journals. He is an editorial board member of BMC Musculoskeletal Disorders, Journal of Aging and Health and ISRN Pain. His research on treatment of musculoskeletal disorders using strength training and kettlebell training has been highlighted in the media, for example, by USA Today, the New York Times and Reuters.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, Copenhagen, 2100-DK, Denmark.
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Reliability of a simple physical therapist screening tool to assess errors during resistance exercises for musculoskeletal pain. BIOMED RESEARCH INTERNATIONAL 2014; 2014:961748. [PMID: 24738079 PMCID: PMC3971509 DOI: 10.1155/2014/961748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/15/2014] [Accepted: 01/19/2014] [Indexed: 11/30/2022]
Abstract
The main objective was to investigate the intra- and intertester reliability of a simple screening tool assessing errors in exercise execution by visual observation. 38 participants with no previous resistance exercise experience practiced for two weeks four typical upper limb exercises using elastic tubing. At 2-week follow-up, the participants were invited for a test-retest assessment on errors in technical execution. The assessment was based on ordinal deviation of joint position from neutral of the shoulder, elbow, and wrist in a single plane by visual observation. Moderate intratester reliability weighted kappa (wΚ) score ranging from 0.50 (0.21–0.71) to 0.57 (0.24–0.82) for observer 1 and a fair to moderate intratester reliability wΚ score ranging from 0.27 (0.09–0.43) to 0.52 (0.15–0.86) for observer 2 across the four exercises was observed. For intertester reliability moderate to substantial mean wΚ scores were found between the two observers, slightly improving from round one to round two ranging from 0.40 (0.20–0.59) to 0.68 (0.45–0.91) in round one to 0.52 (0.20–0.80) to 0.69 (0.39–0.86) in round two. The exercise error assessment demonstrated fair to substantial intratester and intertester reliability, which is congruent with previously published studies. Hence the simplicity of defining a neutral joint position for each of the involved joints in the exercise and categorizing the deviation in “some deviation” and “substantial deviation” to either side in a single plane is a viable and inexpensive solution when assessing for errors during exercise.
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High-intensity strength training improves function of chronically painful muscles: case-control and RCT studies. BIOMED RESEARCH INTERNATIONAL 2014; 2014:187324. [PMID: 24707475 PMCID: PMC3953472 DOI: 10.1155/2014/187324] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 01/02/2014] [Accepted: 01/05/2014] [Indexed: 02/02/2023]
Abstract
Aim. This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions. Methods. Women with trapezius myalgia (MYA, n = 42) and healthy controls (CON, n = 20) participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 16), or a reference group without physical training (REF, n = 8). Participants performed tests of 100 consecutive cycles of 2 s isometric maximal voluntary contractions (MVC) of shoulder elevation followed by 2 s relaxation at baseline and 10-week follow-up. Results. In the case-control study, peak force, rate of force development, and rate of force relaxation as well as EMG amplitude were lower in MYA than CON throughout all 100 MVC. Muscle fiber capillarization was not significantly different between MYA and CON. In the intervention study, SST improved all force parameters significantly more than the two other groups, to levels comparable to that of CON. This was seen along with muscle fiber hypertrophy and increased capillarization. Conclusion. Women with trapezius myalgia have lower strength capacity during repetitive MVC of the trapezius muscle than healthy controls. High-intensity strength training effectively improves strength capacity during repetitive MVC of the painful trapezius muscle.
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Jay K, Sundstrup E, Søndergaard SD, Behm D, Brandt M, Særvoll CA, Jakobsen MD, Andersen LL. Specific and cross over effects of massage for muscle soreness: randomized controlled trial. Int J Sports Phys Ther 2014; 9:82-91. [PMID: 24567859 PMCID: PMC3924612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
PURPOSE/BACKGROUND Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera-band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non-massaged limb. METHODS 22 healthy untrained men (Mean age 34 +/- 7 years; mean height 181.7 +/- 6.9 cm; mean weight 80.6 +/- 6.4 kg; BMI: 24.5 +/- 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0-10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff-legged dead-lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment. RESULTS There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non-massaged limb in the cross over control group compared to controls but this effect was lost 30 minutes post massage. CONCLUSION Massage with a roller device reduces muscle soreness and is accompanied by a higher PPT of the affected muscle. LEVEL OF EVIDENCE 2c; outcomes research.
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Affiliation(s)
| | - Emil Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - David Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s Newfoundland, Canada
| | - Mikkel Brandt
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Markus D. Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars L. Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain: randomized controlled trial. BIOMED RESEARCH INTERNATIONAL 2013; 2013:262386. [PMID: 24490152 PMCID: PMC3892746 DOI: 10.1155/2013/262386] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 11/19/2013] [Accepted: 12/04/2013] [Indexed: 12/04/2022]
Abstract
Purpose. This study investigates the acute and longitudinal effects of resistance training on occupational muscle activity in office workers with chronic pain. Methods. 30 female office workers with chronic neck and shoulder pain participated for 10 weeks in high-intensity elastic resistance training for 2 minutes per day (n = 15) or in control receiving weekly email-based information on general health (n = 15). Electromyography (EMG) from the splenius and upper trapezius was recorded during a normal workday. Results. Adherence to training and control interventions were 86% and 89%, respectively. Compared with control, training increased isometric muscle strength 6% (P < 0.05) and decreased neck/shoulder pain intensity by 40% (P < 0.01). The frequency of periods with complete motor unit relaxation (EMG gaps) decreased acutely in the hours after training. By contrast, at 10-week follow-up, training increased average duration of EMG gaps by 71%, EMG gap frequency by 296% and percentage time below 0.5%, and 1.0% EMGmax by 578% and 242%, respectively, during the workday in m. splenius. Conclusion. While resistance training acutely generates a more tense muscle activity pattern, the longitudinal changes are beneficial in terms of longer and more frequent periods of complete muscular relaxation and reduced pain.
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Tornoe B, Andersen LL, Skotte JH, Jensen R, Gard G, Skov L, Hallström I. Reduced neck-shoulder muscle strength and aerobic power together with increased pericranial tenderness are associated with tension-type headache in girls: A case-control study. Cephalalgia 2013; 34:540-7. [PMID: 24351277 DOI: 10.1177/0333102413515341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 10/29/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Tension-type headaches (TTH) are common among children worldwide and mean a potential risk of disability and medication overuse headache. The associated mechanisms, however, remain unsolved. Our study investigated muscle strength in the neck-shoulder region, aerobic power and pericranial tenderness in girls with TTH compared with healthy controls. METHODS A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well as MVC and rate-of-force development of dominant shoulder, was conducted. VO2 max was recorded by a submaximal ergometer test and pericranial tenderness by standardised manual palpation. Logistic regression analyses were applied. RESULTS Girls with TTH demonstrated significantly higher pericranial tenderness than controls, in correlation with headache frequency (r = 0.66, p < 0.001). Results indicated that the odds ratio of girls having headache are 7.6 (95% CI 1.4-40.9) for weak to strong shoulder muscles; weak to average neck-shoulder strength OR 3.1 (95% CI 1.2-8.1); neck flexion strength OR 1.3 (95% CI 1.0-1.6) and 5.2 (95% CI: 1.4-19.6) for each unit of decrease in VO2 max. CONCLUSIONS Reduced neck-shoulder strength and aerobic power together with increased pericranial tenderness are associated with TTH in girls. Future interventions should be directed towards health promoting patient educational programmes on enhanced physical exercising. Much more exact and detailed research in young girls and boys are needed.
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Affiliation(s)
- Birte Tornoe
- Department of Health Sciences, Lund University, Sweden Children's Headache Clinic, Department of Paediatrics E, University of Copenhagen, Herlev Hospital, Denmark Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Denmark Department of Physiotherapy, Medical Department O, University of Copenhagen, Herlev Hospital, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Ministry of Employment, Denmark
| | - Jørgen H Skotte
- National Research Centre for the Working Environment, Ministry of Employment, Denmark
| | - Rigmor Jensen
- Danish Headache Centre, Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark
| | - Gunvor Gard
- Department of Health Sciences, Lund University, Sweden
| | - Liselotte Skov
- Children's Headache Clinic, Department of Paediatrics E, University of Copenhagen, Herlev Hospital, Denmark
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Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain. J Manipulative Physiol Ther 2013; 36:604-11. [DOI: 10.1016/j.jmpt.2013.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 08/06/2013] [Accepted: 08/08/2013] [Indexed: 01/06/2023]
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